MALARIA DRUG POLICY (2007) - NVBDCP

4. Severe and complicated malaria cases(1) In severe and complicated malaria of P.falciparum(clinically/microscopically confirmed) parenteral artemisinin or quinine is thedrug of choice, irrespective of chloroquine resistance status of the area.(2) Quinine salt .10mg /kg bw 8 hourly in 5% dextrose saline is preferred. Patientsshould be switched over to oral quinine as early as possible and oral dose is10 mg/kg bw eight hourly not exceeding 2gm in a day in any case. Minimumtotal duration for quinine therapy should be for 7 days including both parentaland oral doses.(3) Injectable form of artemisinine derivatives may be used for the management ofsevere and complicated malaria (For adults and non-pregnant only) in thedosage given below: Artesunate: 2.4 mg/kg bw IM/IV followed by 1.2 mg/kg bw after 12 hoursthen 1.2 mg/kg bw once daily for total duration of 5 days. Artemether: 1.6 mg/kg bw IM followed by 1.6 mg/kg bw daily for total of 6injections or 1.6 mg./kg bw IM injection twice daily for 3 days, a total of 6injections. Arteether: 150 mg daily IM for 3 days in adults only. Artemisinin 10 mg/kg bw at 0 and 4 hours followed by 7 mg/kg bw at 24,36, 48 and 60 hours.5. ChemoprophylaxisIn chloroquine sensitive areas-chloroquineIn chloroquine resistant areas-chloroquine+ proguanilChemoprophylaxis is to be started a week before arriving to malarious areafor visitors and for pregnant women prophylaxis should be initiated fromsecond trimester.- 11 -